🩻 Carotid Vulnerable-Plaque Feature Assessment
This tool assesses carotid-plaque vulnerability as a checklist of high-risk imaging features, modifying stroke risk beyond stenosis degree.
Carotid Vulnerable-Plaque Feature Assessment
Intraplaque hemorrhage IPH (MRI T1/MPRAGE hyperintensity)
Large lipid-rich necrotic core LRNC
Thin / ruptured fibrous cap
Plaque ulceration
Ultrasound hypoechogenicity/heterogeneity/juxtaluminal black area (JBA)
When to use
Use to tally vulnerable features (IPH, large lipid core, thin/ruptured cap, ulceration, ultrasound hypoechogenicity) and gauge plaque instability.
How it works
Count high-risk features: 0 → no definite vulnerability, 1 → vulnerable features present, ≥ 2 → highly vulnerable. Intraplaque hemorrhage carries particular weight.
Key points
- Vulnerable features, especially intraplaque hemorrhage, predict ipsilateral stroke independently of stenosis degree, so similar stenosis can carry different risk. (original synthesis · not guideline verbatim)
- The modified AHA-MRI Type VI denotes complex plaque with hemorrhage, thrombus, or cap rupture.
- This is a feature checklist, not a validated score, and supplements rather than replaces image interpretation.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.